Bully Pulpit: Place Your Bets

The world of SCI research is evolving more rapidly now than ever before. The rats and cats and dogs and monkeys have served their time as guinea pigs, and now it’s time to bring the science out of the labs and into the lives of flesh-and-blood human beings, those of us living every moment with paralysis. And there are more of us than most people know.

Some organizations still use the old numbers — 10,000 new SCIs each year, a total of 250,000 in all. But an authoritative Reeve Foundation study released in 2009 puts the number at 1,275,000 people living with SCI, and two, three, or even four times as many new injuries per year as previously thought. So which of the promising scientific approaches will deliver a cure, if any?

A sudden breakthrough in stem cell or Schwann cell human trials could trigger a quantum leap in scientific knowledge and uncover a clear path to a cure. But the nature of the research model itself has a dampening effect. It takes decades to move from animal studies to human trials, and who knows how long — once a cure or significant restorative procedure is identified — before we see it trickle down to the average para or quad?

That’s why I would not wager on stem cells or Schwann cells — or any other cellular research — to improve the lives of more than a tiny fraction of the SCI population anytime soon. But I would wager on the dark horse in the research world, the one that promises less but delivers more. I’m talking of epidural stimulation in combination with locomotor training.

Remember the medical model versus the social model of disability? Now we have two different competing models in SCI research as well — the experimental model versus the therapeutic model. I’m betting on the therapeutic model.

Epidural stimulation delivers measurable, practical results in a fraction of the time that experimental procedures can be approved, conducted, and evaluated. While the stem cell world thinks in terms of getting people walking — perhaps — someday, epidural stimulation trial participants are regaining previously lost functions in a matter of months. Improved muscle mass, circulation and healing, bladder and bowel improvements, sexual performance, temperature control, even cardiovascular fitness is improving during trials. And the potential to translate results to a larger population is much more doable than with experimental research.

The beauty of epidural stimulation research is that it works with what we have, not with what we don’t have. We have spinal cords that are mostly intact, and epidural stimulation is teaching us how to “turn on” complex circuitry that has lost its power source. We have muscles that can maintain or even regain muscle tone, and we are learning how to reactivate them in ways that are beneficial for our health.

While experimental research introduces as yet unknown possibilities into our bodies, epidural stimulation attempts to understand and maximize the body’s existing potential. I can’t think of a better place to begin.